“Chronic pain has no solution”

The title of this is a quote is from a couple month old Time Magazine article. I feel bad for anyone who has chronic pain, which, according to the article, is a damn good amount of people (76 million). Because the article is essentially telling these people, “You are completely screwed, so just start popping pills.”

There were a couple articles in the issue and they both have a central theme of focusing on the nervous system and stopping pain through the nervous system i.e. manipulating the brain and such. At no point in the issue does anyone seem to address why the nervous system is pissed to begin with. What is causing the pain??

The brain doesn’t just send signals to the appendages or site of pain and say, “Hey, just act annoyed for no reason.” The appendages or site of pain send signals to the brain as well, telling the brain, “Hey, we’re already pissed off.”

One of the articles uses a woman who has chronic wrist pain. The woman worked for a company where she repaired and transported slot machines. Each machine weighed between 50 and 300lbs. This woman in her spare time noted carrying “huge buckets of water” and throwing “100lb hay bales around a barn.”

One day while lifting a slot machine she heard her wrist pop. She’s been in chronic pain ever since, much to the wonderment of multiple doctors. Multiple doctors performed imaging on her wrist and found nothing. Eventually she has an operation on her spine to override the pain she feels.

Now I don’t know very much about this woman, but did anyone ever, just maybe, suspect that hauling 50- 300lb machines, carrying 100lb hay bales around and riding a horse (more grabbing) for probably YEARS, might have pissed off this woman’s wrist???

Lord only knows the muscular imbalances that woman has in her forearm and hand after that kind of toll. But not until doctor number seven was there even a mention of some type of physical therapy, which could actually correct the imbalances unlike spinal surgery. Right after her initial injury her first doctor gave her a script for Vicodin and sent the woman home. End of treatment. Yay for healthcare.

“Chronic pain really is a disease of the central nervous system.”

Another quote I have issues with. Now some of the article talked (briefly) about chemotherapy and amputee patients dealing with pain even after their cancer or limb is gone. So, this quote may be dealing with them, but, considering 80% of chronic pain sufferers are dealing with musculoskeletal pain, let’s consider this quote for that population.

Again, there is a reason the brain is yelling out pain: Most likely because the person is causing / performing a painful activity! That is, I would love for that quote to say: The majority of chronic pain is a disease of the movement system.

Think about it this way: If I punch you in the arm 100 times each day, your brain is going to get pissed off eventually. What’s the most efficient, least invasive way to get rid of this pain? To take drugs, have spinal surgery, or get me to stop punching you in the arm?

Movement is the same way. Often times the best way to get rid of somebody’s lower back pain is to alter how they move….at the lower back. This is so often overlooked though. Have a herniated disc? Let’s just do surgery. Never mind why the disc was herniated. Which completely overlooks the fact the surgery is not going to solve what caused the disc to be herniated in the first place. So another herniation and or back injury is waiting in the wings to happen again.

Take this video below as an example. This is a woman who has had chronic wrist pain. Watch how her wrists move in relation to one another and see if you notice any asymmetries:

Look at the right side and the amount of ulnar deviation (wrist turns to the outside) happening when she flexes her wrist. When she gets to the end range of motion on her right wrist is when she feels pain. So, to get her some pain relief we get her to stop turning her wrist outward so much and get her to eliminate activities that encourage this motion. For example, many people with wrist pain type like this:

Get them to type with their wrists and elbows straight and suddenly a lot of their wrist pain clears up.

Yet, according to Time Magazine, our options are 1) Take drugs or 2) perform SPINAL surgery. Again, maybe this woman’s wrist is so wrecked she is beyond repair. However, it’s a shame a treatment process like this doesn’t even seem to be considered.

Soon I’m going to present some case studies of people who have or had chronic pain and how they are managing to alleviate and eliminate their pain. Just because your shoulder has hurt for a couple of years does not mean it has to hurt for the rest of your life.

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I think you are on the right track with everything you write, but you need to realise the phenomenon that is central sensitisation. Not every pain experience can be attributed to movement disorders. I’ve read janda and sahrmanns texts and even anatomy trains and they are great reads. But they fail to recognise the psychological component of chronic pain. If you read explain pain or anything by butler and Moseley I swear you will be much more aware of the brains involvement. They’re great reading.

Think about it this way: If I punch you in the arm 100 times each day your brain is going to get pissed off eventually. What’s the most efficient, lease invasive way to get rid of this pain though? To take drugs, have spinal surgery, or get me to stop punching you in the arm?

addresses central sensitization.

C.S. can be quite a good thing when treating people in pain as well. It’s easier to 1) Figure out what’s causing their pain (e.g. which movements) and 2) Teach them what to avoid. C.S. doesn’t break the rule of you still need to address the cause of the pain, which is almost always how they move. Sahrmann addresses these aspects in this interview: http://www.youtube.com/watch?v=faEzHR5zLjs

Very informative, I’ve been dealing with chronic neck, trap and scapula pain for 1.5 years. (due to surgery to set a broken clavicle).
Your website came up in one of my google searches and I have been reading post after post. The wrist example is great, what’s even worse though is when a doctor can only tell you, “surgery might alleviate the pain but we are not sure”. Thanks for your detailed posts I’ll def be emailing you soon. PS, ordered “Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines” Started reading the pages shown on amazon and had to order it.